TY - JOUR
T1 - La puntuación de Harada no debe utilizarse como predictor de aneurismas coronarios en niños mexicanos con enfermedad de Kawasaki
T2 - Análisis de la Red de Vigilancia de Kawasaki en México
AU - De Jesús Coria-Lorenzo, José
AU - Balderrábano-Saucedo, Norma Alicia
AU - Ramírez-Bouchand, Daniel
AU - Jiménez-Juárez, Rodolfo Norberto
AU - Ramírez-Rivera, Roselia
AU - Reyes-López, Alfonso
AU - Enciso-Peláez, Sandra
AU - Unda-Gómez, Jaime Julio
AU - Sotelo-Cruz, Norberto
AU - Gutiérrez-Ceniceros, Michel
AU - Martínez-Medina, Lucila
AU - Enríquez-Cisneros, Omar
AU - Díaz-Toquero, Alejandro
AU - Díaz-Luna, José Luis
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Objectives: To evaluate if the criteria of the Harada score (HS) are useful as predictors of coronary aneurysm in a population of Mexican children with Kawasaki disease. Material and methods: We carried out a review of the clinical records of children with a diagnosis of KD who developed coronary aneurysms, and who were cared for in nine hospitals of the Mexican Republic from January 2008 to December 2012; we assessed their HS, which includes the following criteria: 1. Leukocyte count > 12,000/mm3; 2. Platelet count < 350,000/mm3; 3. CRP > 3; 4. Hematocrit < 35%; 5. Albumin < 3.5 g/dL; 6. Age ≤ 12 months, and 7. Male sex. It is positive when the patient presents four of these criteria. All the patients studied had an echocardiogram in the acute phase, and at least another during evolution. Results: We studied 179 patients, 111 male (62%), aged 2 months to 18 years. Thirty-five patients with HS of three or less (76%) and twenty-eight with HS of four or more (100%) had a lesion in the coronary arteries: 21, coronary aneurysm (15 of them in both coronary arteries) and 11, coronary ectasia (associated with an aneurysm in another coronary in four). There were only six patients with a score of five. The HS had a sensitivity of 21%, a specificity of 52%, a positive predictive value of 22% and a negative predictive value of 86%. Conclusions: The HS in a child with KD is useful since it can be a predictor of high risk for developing coronary aneurysms when the value is greater than four, and of very high risk when it is five. Nevertheless, children with HS of three or less must have a closer follow-up, with frequent echocardiograms, since the HS is not reliable.
AB - Objectives: To evaluate if the criteria of the Harada score (HS) are useful as predictors of coronary aneurysm in a population of Mexican children with Kawasaki disease. Material and methods: We carried out a review of the clinical records of children with a diagnosis of KD who developed coronary aneurysms, and who were cared for in nine hospitals of the Mexican Republic from January 2008 to December 2012; we assessed their HS, which includes the following criteria: 1. Leukocyte count > 12,000/mm3; 2. Platelet count < 350,000/mm3; 3. CRP > 3; 4. Hematocrit < 35%; 5. Albumin < 3.5 g/dL; 6. Age ≤ 12 months, and 7. Male sex. It is positive when the patient presents four of these criteria. All the patients studied had an echocardiogram in the acute phase, and at least another during evolution. Results: We studied 179 patients, 111 male (62%), aged 2 months to 18 years. Thirty-five patients with HS of three or less (76%) and twenty-eight with HS of four or more (100%) had a lesion in the coronary arteries: 21, coronary aneurysm (15 of them in both coronary arteries) and 11, coronary ectasia (associated with an aneurysm in another coronary in four). There were only six patients with a score of five. The HS had a sensitivity of 21%, a specificity of 52%, a positive predictive value of 22% and a negative predictive value of 86%. Conclusions: The HS in a child with KD is useful since it can be a predictor of high risk for developing coronary aneurysms when the value is greater than four, and of very high risk when it is five. Nevertheless, children with HS of three or less must have a closer follow-up, with frequent echocardiograms, since the HS is not reliable.
KW - Coronary aneurysms
KW - Harada score
KW - Kawasaki disease
UR - http://www.scopus.com/inward/record.url?scp=85028321003&partnerID=8YFLogxK
M3 - Artículo
SN - 0035-0052
VL - 84
SP - 92
EP - 100
JO - Revista Mexicana de Pediatria
JF - Revista Mexicana de Pediatria
IS - 3
ER -